Older patients with cancer often have many medications that need to be managed; therefore, in a study published in The Oncologist, researchers explored the feasibility of integrating pharmacists into patient care and the impact this would have on medication and vaccination management.
In this study, 60 patients aged 65 years and older receiving first-line chemotherapy for lung, breast, or gastrointestinal cancer were randomized to their respective usual care regimen or a pharmacy intervention incorporated into their care. Electronic health records (EHRs) and patient reports were reviewed at baseline and at week 4 to assess discrepancies between the 2 data sources as well as to identify possibly inappropriate medications.
The intervention was a visit with a pharmacist at the second or third chemotherapy infusion visit. The pharmacist conducted a history, reviewed current medications, and communicated and recorded observations and/or recommendations. Feasibility of the intervention, the primary study end point, was achieved if 75% or more of the patients in the intervention cohort met with the pharmacist.
The pharmacist visit occurred in 96.6% of patients in the intervention cohort. Furthermore, influenza and pneumonia vaccination rates were significantly higher in this group by week 4, compared with the usual care group (27.6% vs 0% and 27.6% vs 0%, respectively).
Occurrences of potentially inappropriate medications or discrepancies were lower in the intervention cohort compared with the usual care cohort, but not significantly so.
The authors concluded that integrating pharmacists into care for older patients with cancer was feasible, and it demonstrated a positive effect on vaccination rates, possibly enabling improved medication management as well.
Nipp RD, Ruddy M, Fuh CX, et al. Pilot randomized trial of a pharmacy intervention for older adults with cancer[published online October 19, 2018]. Oncologist.doi: 10.1634/theoncologist.2018-0408